Pregnancy Care: Pain Relief during labour

Pregnancy Care: Painless delivery, benefits and side effects

In pregnancy, labour pains are the most difficult step for the mother and baby. Maximum number of issues arise in this time. Pain relief is best thought through well before labour takes place. You need to know the choices that are available and to think clearly about what is suitable for you so that you can make decisions quickly on the day itself in pregnancy. We will discuss the options, types of painless delivery options to avoid labour pain along with its benefits and side effects.

Entonox is the mixture of oxygen and nitrous oxide (commonly known as “Laughing Gas“). It makes you feel light-headed and takes the edge of pain of uterine contraction – enough for many women to cope without any other help. It is mostly used towards the end of the first stage of labour as well as during the second stage. To use entonox, you hold the mask over your face at the start of each contraction for a few minutes, taking deep, steady breaths. You will probably be able to try this out at antennal classes. it takes about 20 to 30 seconds for the gas to be effective and the relief lasts for about a minute.

Pros:

Entonox is often under-rated. It is the simplest kind of pain relief and is safe for both mother and baby.Entonox contains a high percentage of oxygen and because nitrous oxide is relatively non-commutative, it is safe to prolong its administration with low risk. It is easy to use and it is the only method under your control. You can choose when to have it and when not to have it. It has added advantage of giving you something to do, thus distracting you from the labour pain in pregnancy.

Cons:

Some women find it less effective and insufficient. Main issue is with the mask which may be unpleasantly claustrophobic and cumbersome. It can be rather tiresome to repeatedly apply and to force-inhale. It can be high woozy feeling.

Pethidine is a sleep-inducing drug which relieves or lessens pain during uterine contractions and aids in relaxation. It is given by intramuscular injection usually around the end of the first stage and when the going gets tough. It takes effect in about 20 minutes and pain relief lasts for two to four hours.

Pros:

Just like entonox, pethidine lessens the pain considerably although it does not take it away altogether. This give you a break from constant pain during the long first stage.

Cons:

While the effect of pethidine may be pleasantly relaxing and euphoric for some, it makes other feel sick and drunk. If it is given two hours or so before labour, you may find it somewhat difficult to push because of the sedative effect. It passes through placenta and depresses the baby’s breathing at birth. It also makes the baby drowsy. If this happens, an antidote called Narcan can be given to reverse these effects when the baby is born.

An epidural is a special kind of anaesthesia which numbs the nerves that carry pain from the uterus and cervix to the brain. It removes sensation from the waist down during labour in pregnancy. In order to administrator the anaesthetic, you need to lie curled on your side or bent forward at the edge of the bed.

A local anaesthetic is then given, following which a fine needle is carefully inserted into the epidural space that lies between the spinal column and the spinal cord. Then a fine plastic tube is threaded down the needle and taped into place through which top-ups of anaesthetic can be given and the needle removed.

This procedure is done by a specially trained anaesthetic and takes about 20 minutes to perform. Within 10 minutes of so of administering the anaesthetic, you should be completely free of pain. An epidural anaesthetic can be administered at the onset of labour or when uterine contractions become sufficient painful.

Pros:

Epidural is total pain relief if properly administer and does not interfere with contractions. It is valuable if labour/delivery is long and difficult. This procedure is very good in case of delivery of twins, breech babies or premature babies as the relaxed pelvic floor causes less cranial stress to the baby. It will leave you fully conscious.

Cons:

Unfortunately small percentage of epidural are not effective. Women are left with small area of pain or on one side. Movement is limited. Contractions are continuously monitored due to the fact that you don’t feel any contraction or pain. If not properly guided, second stage of labour can be prolonged. A drip is usually given and since you will not be able to feel when you want to pass urine, a fine tube is inserted into your urethra to empty your bladder.

The procedure can cause injury to the spinal cord and spinal nerves. If the needle enters the spinal canal, there will be spinal leak which can lead to headaches and other complications. Secondary infection may also occur, leading to infection of the spinal membranes.

No therapeutic method is without its inherent risks; similarly for methods of painless labour. However three methods described here are effective and quite safe for use. Nevertheless, it is important to realise that proper supervision is still required to minimise any possible complications.

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